Sleep normally occurs in several stages. The sleep cycle includes:
The sleep cycle is repeated several times during the night.
Sleep patterns tend to change as you age. Most people find that aging causes them to have a harder time falling asleep. They wake up more often during the night and earlier in the morning.
Total sleep time stays the same or is slightly decreased (6.5 to 7 hours per night). It may be harder to fall asleep and you may spend more total time in bed. The transition between sleep and waking up is often abrupt, which makes older people feel like they are a lighter sleeper than when they were younger.
Less time is spent in deep, dreamless sleep. Older people wake up an average of 3 or 4 times each night. They are also more aware of being awake.
Older people wake up more often because they spend less time deep sleep. Other causes include needing to get up and urinate (nocturia), anxiety, and discomfort or pain from long-term (chronic) illnesses.
EFFECT OF CHANGES
Sleep difficulty is an annoying problem. Long-term (chronic) insomnia is a major cause of auto accidents and depression. Because older people sleep more lightly and wake up more often, they may feel deprived of sleep even when their total sleep time has not changed.
Sleep deprivation can eventually cause confusion and other mental changes. It is treatable, though. You can reduce symptoms when you get enough sleep.
Sleep problems are also a common symptom of depression. See a health care provider to find out whether depression or another health condition is affecting your sleep.
Older people respond differently to medicines than do younger adults. It is very important to talk with your provider before taking sleep medicines. If possible, avoid sleep medicines. However, antidepressant medicines can be very helpful if depression affects your sleep. Some antidepressants do not cause the same side effects as sleep medicines.
Sometimes, a mild antihistamine works better than a sleeping pill for relieving short-term insomnia. However, most health experts do not recommend these types of medicines for older people.
Use sleep medicines (such as zolpidem, zaleplon, eszoplicone or benzodiazepines) only as recommended, and only for a short time. Some of these medicines can lead to dependence (needing to take the drug to function) or addiction (compulsive use despite adverse consequences). Some of these drugs build up in your body. You can develop toxic effects such as confusion, delirium, and falls if you take them for a long time.
You can take measures to help you sleep:
If you cannot fall asleep after 20 minutes, get out of bed and do a quiet activity, such as reading or listening to music.
When you feel sleepy, get back in bed and try again. If you still cannot fall asleep in 20 minutes, repeat the process.
Drinking alcohol at bedtime may make you sleepy. However, it is best to avoid alcohol, because it can make you wake up later in the night.
Barczi SR, Teodorescu MC. Psychiatric and medical comorbidities and effects of medications in older adults. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 191.
Miner B, Lucey BP. Normal aging. In: Kryger M, Roth T, Goldstein CA, Dement WC, eds. Principles and Practice of Sleep Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 3.
Sterniczuk R, Rusak B. Sleep in relation to aging, frailty, and cognition. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 108.
Walston JD. Common clinical sequelae of aging. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 22.BACK TO TOP
Review Date: 7/21/2022
Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Health Content Provider
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2023 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.